From Community-Academic Partnerships
Travers is a scientist and the Director of Community-Based Research
at the Ontario HIV Treatment Network
(OHTN) located in Toronto, Canada. OHTN optimizes the quality of life
of people living with HIV in the Province of Ontario and promotes excellence
and innovation in treatment, research, education and prevention. Robb
explains that OHTN
would advocate for the inclusion of policy-makers
on CBR [Community-Based Research] teams. The current mode of knowledge
uptake rests on a linear belief that research data will lead to
policy changethat policy-makers will respond to data proactively.
Most of us know that the world of policy change is actually more complex
than that, and broadening our perspective from community-academic
partnerships to community-academic-policy partnerships
will help to ensure that the core principle of CBRACTIONis
Located in Toronto, Canada, the Ontario HIV Treatment Networks (OHTN) mission is to optimize the quality of life of people living with HIV in the Province of Ontario and to promote excellence and innovation in treatment, research, education and prevention through a collaborative network of excellence representing consumers, providers, researchers and other stakeholders.
Our new Strategic Plan to 2010 prioritizes several areas that involve actively building capacities among and mobilizing partnerships between communities and academic researchers. Here are three examples:
Visit: http://www.ohtn.on.ca/documents/OHTN_Strat_0505.pdf for more on our Strategic Plan to 2010.
Through our CBR Team and our Community Network, we effect positive change through capacity-building, partnership brokering, mobilizing knowledge, and funding and facilitating excellence in HIV research (including CBR) in Ontario.
OHTN is a dynamic organization with an ambitious and cutting-edge Strategic Plan; this is operationalized by a highly motivated and experienced team committed to utilizing multiple methods and innovative programming initiatives to enhance quality of life among people living with HIV/AIDS and communities at risk.
If we could highlight one truly innovative aspect about OHTN it is that
we listen to what our communities and stakeholders ask of us and we deliver.
Were able to do this because our staff team, our Board of Directors,
and our committees are inclusive of the communities we serve. In fact,
more than half of our Board of Directors is comprised of members of community-based
organizations and/or people living with HIV/AIDS.
The OHTN is unique in many ways. First, we recognize that the HIV epidemic is driven largely by factors that are beyond the control of individuals; the social determinants of health framework provides a unique lens for helping us understand how and why HIV has increasingly become a disease of the margins. One key example of this is the Housing and Health Initiative that OHTN helped to launch over the last year (http://www.healthyhousing.ca/).
The program initiatives emerging from our Strategic Plan give our stakeholders (including communities infected and affected by HIV) the tools they need to effect positive change at these broader systemic levels. Last year, OHTN invested $425,000 in research initiatives that help us better understand the story behind the story in HIV infectionhow the social determinants affect disease progression and new infections. In addition, in this years funding calls, we are strategically investing in research disciplines that can assist in enhancing our understanding of how the social determinants of health impact HIV including social science, epidemiology and CBR. Moreover, we are able to offer student placements so that we nurture a new generation of researchers fluent in CBR and knowledge transfer and exchange approaches.
Second, in order to solve the complexity of health problems facing people living with HIV/AIDS and communities at risk, these individuals need to be at the table in research partnerships, in determining priority areas for research, in conducting the research itself, and in determining how best to strategically use new knowledge to effect change. To facilitate this, we are proactively implementing programming that supports the development of community-academic partnerships. Numerous and exciting initiatives have been implemented to enhance the capacities of our community partners to equitably participate in CBR (last year we spent close to $100,000 on such initiatives). One example is the generous scholarships program we provided to the 4th International Conference on Urban Health held here in Toronto in 2005; in 2007, we will also be a major contributing partner in CCPHs 10th Anniversary Conference in Toronto. Another example of excellence is the Living and Serving II Project a community-based study that is examining barriers to PHA (people living with HIV/AIDS) participation in the HIV movement in Ontario (results to be launched in November, 2006). Another is the Compass Community Toolkit to be launched in partnership with the Ontario AIDS Network in November, 2006. This unique web-based resource provides how-to advice on all aspects of CBR to various stakeholders.
Third, we ensure that our capacity-building initiatives are driven by evidence. As such, the OHTN, in collaboration with the Ontario AIDS Network, is near completion of a study of Executive Directors of AIDS Service Organizations in Ontario that will help us better understand barriers and facilitating factors for CBR and capacity-building needs. This will help us target resources and energies as we move into the future, and will provide baseline data by which we can measure the success of our initiatives.
Fourth, we strive to ensure that we use the broad range of tools at our fingertips to meet our strategic goals. Our funding tools are innovative and cutting-edge and reflect priority areas in the epidemic that require strategic investmentsCBR is among those very important areas. Last year, we were able to dedicate more than $400,000 in funding for developmental/capacity-building initiatives in support of CBR (http://www.ohtn.on.ca/pdf/Capacity_Build_Aug05.pdf)
We are passionate about building CBR and knowledge mobilization initiatives that attend to the needs and capacities of a very diverse set of stakeholders across Ontario, from the ground-up. We are passionate about our staff team and ensuring that we have diverse skill sets to match the program initiatives we engage in. Finally, we are most passionate about thinking outside of the box and continually pushing ourselves to create programming initiatives that enhance quality of life for communities at risk or for people living with HIV/AIDS.
We have quickly become a Canadian leader in HIV-related CBR. Synergizing our efforts with national partners such as the Canadian Institutes of Health Research, provincial leaders such as the Community-Linked Evaluation AIDS Resource, the Ontario AIDS Network, and the AIDS Bureau at the Ontario Ministry of Health and Long-Term Care, as well as local champions like the AIDS Committee of Toronto, allows us to build networks and shape hubs of excellence that help academic researchers and community groups take CBR to levels previously unseen in Ontario and in Canada.
We also envision a time in the not-too-distant future where the gaps between policy and practice in the HIV sector are narrowed through the knowledge gleaned from rigourous CBR and community-driven policy strategies. We see a time when CBR is a core part of the work that communities undertake if they so choose.
5. What wisdom would you like to communicate to others in this field or to your colleagues (similar to tips and lessons learned)? What advice would you give to others? What advice would you give to a student or professional just entering into the field?
Excellence in CBR is dependent upon building strong organizational and institutional cultures that are excited by and supportive of CBR. Having the right people at the table at the right time (especially those who bring a history of trusting working relationships) helps to ensure action. Successful CBR projects also require resources and innovation in how we think about knowledge mobilization. Institutionally-based researchers and CBR partners often run out of time and money to effect desired community and policy level changes. Well-designed knowledge transfer initiatives ensure that the intended goals of CBR projects are achieved. Last year, we spent $152,000 to help researchers and community groups share knowledge. Currently, we are developing a Knowledge Mobilization fund that will provide community groups, researchers and other stakeholders the monies they need to build even more innovative and comprehensive knowledge transfer strategies that will help to ensure that research findings get into the hands of those who can actually effect change. At OHTN, we also continue to devise other innovative methods and work with our partners to design and implement Think Tanks, seminar series, newsletters, and videos that bring research data to life in useable formats. One example of excellence is our new Compass newsletter that highlights excellence in HIV-related CBR. Launched in partnership with the Ontario AIDS Network and the Community-Linked Evaluation AIDS Resource the first issue will be released at the International AIDS Conference in Toronto next month (see for more details http://www.ohtn.on.ca/compass.htm).
We have also found Think Tanks to be an extremely useful means of creating a buzz about new and emerging areas of concern to community and other stakeholders. To date, we have sponsored Think Tanks on housing and HIV, immigration and HIV, mental health and addictions and HIV, and needle exchange programs. One recent Think Tank helped to launch an invaluable new document entitled Best Practice Recommendations for Needle Exchange Programs in Ontario. Our follow-up activities have included the development of a web page devoted solely to the Think Tank. On this page, readers can access the full Best Practices document, video presentations from guest speakers, presentation slides, a summary report of the day, and access to a 10 minute documentary (created for the Think Tank) highlighting a day in the life of a needle exchange program in Ontario (see for more details http://ohtn.on.ca/nep.htm).
One of the biggest challenges we face is ensuring that we pay balanced and sufficient attention to understanding barriers and facilitating factors for CBR for both community and academic stakeholders. Many organizations supportive of CBR focus the majority of capacity-building resources and energies on community organizations, which may unintentionally create a lack of understanding about barriers and facilitating factors for CBR among academic partners. To ensure capacity-building for successful CBR, we must be proactive in ensuring that we fully understand the environments and cultures in which community members and academic researchers work. Community organizations focus their efforts on increasingly complex client loads and CBR may therefore not be an organizational priority. In addition, the nature of academic environments, largely speaking, rewards research and publishing more so than it does community-engaged scholarship. To be successful in our CBR endeavours, we need to do all that is possible to shift this paradigm so that community-engaged scholarship is equally rewarded. If we view academics as not-to-be-trusted enemies, we may unintentionally hurt CBR in the long-run by limiting the pool of researchers available to community partners. While building trust and correcting past harms is crucial to successful CBR, so is understanding the barriers and facilitating factors for academic engagement in CBR. As such, the OHTN, along with a number of HIV researchers in Ontario and beyond, is leading a study to help us better understand the concerns of academic researchers in Ontario interested in CBR.
We would first argue that communities play crucial roles in helping to unravel the complexities of HIV issues by bringing members knowledge and lived experience to the table. Without this in-depth kind of input, our ability to address and understand the social determinants of health is severely limited and there would be little substantial change in shifting the HIV epidemic. Second, given the importance of CBR in enhancing our understanding of the epidemic, we would advocate for the inclusion of policy-makers on CBR teams. The current mode of knowledge uptake rests on a linear belief that research data will lead to policy changethat policy-makers will respond to data proactively. Most of us know that the world of policy change is actually more complex than that, and broadening our perspective from community-academic partnerships to community-academic-policy partnerships will help to ensure that the core principle of CBRACTIONis realized.
We would describe CCPH (and this is why we joined) as the leading North American organization in facilitating the development of community-university partnerships. The available resources, the shared wisdom, and the opportunity to have an organization that feels like it was developed for us are truly important. We joined as an organizational member because we want to do all possible to create an organization-wide culture supportive of CBR. We also wanted to utilize the tools CCPH has to offer for our own capacity-building, and to help ensure that team members at OHTN are speaking a common language and developing a shared vision of CBR.
At OHTN, a community-campus partnership involves an inclusive and equitable partnership between community organizations/members and researchers working in an academic institution or hospital. Increasingly, we are working to ensure the engagement of policy makers from the inception of projects. We encourage the creation of mechanisms to ensure shared decision-making and equal participation throughout the research process (as this is defined and agreed to by all partners on the research team); this assumes a commitment to addressing socio-economic barriers to participation in the research process. Each partner contributes to the research process according to their expertise and resources, and each receives benefit in accordance with their respective interests. At OHTN each research project considers the communities that are implicated by the research being undertaken. While the specific composition of who is included within any definition of community will vary according to the scope and focus of individual research projects, all research projects supported by OHTN strive to ensure that the outcomes of research optimize the quality of life of people living with HIV/AIDS (PHAs) and communities at risk. OHTNs definition of community includes people living with and affected by HIV/AIDS, community-based organizations/groups that provide services for PHAs and those at risk, and community-based organizations/groups that advocate on behalf of PHAs and those at risk.
CCPH membership allows us to keep abreast of valuable resources as we
move forward with implementing our Strategic Plan. The complexity of issues
related to building partnerships, enhancing capacities, funding and facilitating
CBR, and supporting community-driven knowledge mobilization and policy
work demands that we have resources, best practice examples, people and
networks at our fingertips. CCPH provides significant access to a rich
array of these assets, thereby assisting us in our tasks. Our favourite
parts of CCPH are the on-line and print resources
, the annual conference
The OHTN not only provides funding for HIV research but also conducts its own internal research initiatives and is therefore in a position to facilitate CBR on several fronts. Through the OHTNs dedicated funding stream for CBR projects it is able to fund projects that use community partnership building to address priority research areas for HIV (e.g. housing for people living with HIV/AIDS, mental health and addictions concerns, and issues for new immigrants and refugees living with HIV/AIDS). Furthermore, through the CBR capacity-building funds, the OHTN is helping community organizations develop research protocols, build strategic alliances, enhance their research skills and assess their research needs. In addition to funding research, the OHTNs internal research activities serve to strengthen existing partnerships (while creating new ones) between community organizations and academic institutions. Lastly, the OHTNs knowledge transfer and exchange (KTE) strategies tie all of its research initiatives together by ensuring that new knowledge is shared and used to improve care, treatment and prevention services, and to shape policy. Through all of these initiatives, the OHTNs major strength is that it offers a breadth of perspective (and an increasing amount of cumulative wisdom) on creating and sustaining partnerships with community organizations for the purpose of generating knowledge that is useful for the communities that it serves.
Were passionate about our work because we see results. We are beginning to clearly understand how knowledge from CBR studies can be mobilized to create real change in communities. We see the benefits from CBR studies in enhanced capacities, stronger research partnerships, and policy-level changes. Were a passionate group of individuals committed to the communities that we are part of and that we work on behalf of.